At the present, there is a need for a viable vacuum formed, non-invasive, inexpensive custom breathing appliance. Most sleep apnea appliances have been made of bulky boil & bite materials. More specifically, there is a need for a dental office manufacturing method utilizing techniques and machines in most dental offices to manufacture a removable mandibular advancement appliance which can use elastic bands to pull the jaw forward and bite pads to open the bite vertically. In addition to the foregoing, other method aspects are described in the claims, drawings, and text forming a part of the present disclosure.